Klin Farmakol Farm. 2009;23(4):166-170

Systemic oral enzyme therapy after lumbar disc herniation surgery

Lubomír Pekař¹, Jiří Steindler²

¹ Neurochirurgická klinika FN Královské Vinohrady v Praze

² Oddělení neurochirurgie FN Motol v Praze

The aim of this open pilot observation was to prove the influence of the long-term oral systemic enzyme therapy (SE) on subjectively

perceived pain, disabilities caused by back pain and development of late postoperative complications after lumbar disc herniation

surgery.

Patients after lumbar disc herniation surgery (n = 100; aver. age 41,99 year, SD ±9,06) were randomly divided into two groups. All patients

were administered by analgesics and underwent physiotherapy after surgery. The SE group (n = 50, aver. age = 41,24 year, SD ±9,86) was

administered by combined enzyme preparation Phlogenzym (bromelaina 90 mg, trypsinum 48 mg rutosid 100 mg), besides the usual

post-operative treatment. The control group KO (n = 50, aver. age = 42,74 year, SD ±9,39) underwent obligatory treatment only.

Preoperative and postoperative status was evaluated according to Visual Analog Scale (VAS), Roland-Morris questionnaire (RMQ) and

Oswestry Disability Index (ODI). Subjective evaluation of improvement, development of failed back surgery syndrome (FBSS) and ability

to work after surgery were other objectives of the follow-up. Statistical evaluation of the results was accomplished.

Statistically significant differences between individual groups were proved for the benefit of the SE group in subjectively perceived

pain (VAS, p = 0,025), disability for lower back pain (RMQ, p = 0,0006) and in the difference of the patients’ disabilities in common daily

activities (ODI, p = 0,023).

The difference in late postoperative surgery complication occurrence was close to the significance level (p = 0,08). No difference in the

influence of SE therapy on the ability to work (p = 0,68) was found.

This follow-up results are stimulating for continuing research of SE as supportive treatment for patient after lumbar disc herniation surgery.

Keywords: lumbar disc disease, postoperative treatment, failed back surgery syndrome, systemic oral enzyme therapy

Published: May 1, 2010  Show citation